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qa specialist resume example with 13+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Summary

Detail-oriented Medical Receptionist with 10-year background performing basic clerical tasks to keep office running smoothly. Organized and meticulous individual with outstanding phone demeanor and etiquette paired with deep knowledge of medical terminology. Collaborative team player dedicated to helping patients and staff. Skilled administrative team member with in-depth understanding of medical standards, compliance requirements and operational procedures. Practiced problem-solver with friendly and caring mentality and excellent communication skills. Expertise in inventory management, customer service and inner-office operations.

Skills
  • Correction action planning
  • Collaboration skills
  • Quality Assurance
  • Communication proficiency
  • Problem-solving skills
  • Reporting and documentation
  • Friendly, positive attitude
Experience
QA Specialist, 06/2012 to Current
Alphanumeric SystemsEast Durham, NY,
  • Monitored QA procedures for adherence by employees, notifying personnel of non-compliance issues.
  • Reviewed received payments for accuracy and applied to intended patient accounts.
  • Filed and submitted insurance claims.
  • Reviewed medical records to meet insurance company requirements.
  • Documented and filed patient data and medical records.
  • Maintained up-to-date understanding of insurance payment practices.
  • Expertly assigned charges and payments for medical procedures.
  • Verified final claim submissions by comparing account charges with documentation.
  • Performed routine quality assurance audits to promote data integrity.
  • Compiled and maintained logs, and statistical or research records to locate requested health data.
  • Completed and submitted appeals for denied claims.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Handled billing, waivers and claims for private and commercial clients.
  • Submitted and accurately processed insurance claims with related medical code verifications and assessments.
  • Received underwriting approvals after accurately completing applications for insurance coverage.
  • Entered insurance, demographics and health history into patient database.
  • Called patients to confirm scheduled appointments and obtain additional details.
  • Checked patients in and out for appointments and collected co-payments.
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
  • Processed patient payments and scanned identification and insurance cards.
  • Protected patients by observing strict HIPAA guidelines.
  • Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
  • Greeted each patient pleasantly and offered desk sheet for easy sign-in.
  • Delivered high-quality administrative and customer service to sustain patient and work flows.
  • Carried out daily tasks by professionally communicating with physicians, nursing staff, technicians and medical assistants.
  • Retrieved faxes and uploaded documents to patient charts to assist clinical staff.
  • Informed patients of financial responsibilities prior to rendering services.
  • Handled correspondence, managed files and performed other clerical duties for office staff.
  • Conducted patient intake interviews to collect medical information and insurance details.
Receptionist, 09/2011 to 02/2012
Gfa InternationalJacksonville, FL,
  • Pulled and organized requested documentation.
  • Worked with office manager to attain operational goals.
  • Answered and directed incoming calls using multi-line telephone system.
CR and Phlebotomy, 10/2007 to 06/2011
Albany Memorial HospitalCity, STATE,
  • Obtained variety of blood samples through venipuncture or capillary puncture using syringes, butterfly needles and straight needles.
  • Labeled blood vials with critical information like time of collection, date and patient name.
  • Prepared blood-collecting equipment to draw blood and safely store and transport samples.
  • Maintained fully-stocked phlebotomy cart, carrier and station.
  • Counseled patients to ease fears, explain procedures and enhance cooperation during blood draws.
  • Coordinated workflow based on stat, schedule, or outpatient needs.
  • Interviewed patients and documented details to update and file paperwork.
  • Used multiple electronic medical software to conduct patient intakes and send correspondence.
  • Entered insurance, demographics and health history into patient database.
  • Protected patients by observing strict HIPAA guidelines.
  • Delivered high-quality administrative and customer service to sustain patient and work flows.
  • Carried out daily tasks by professionally communicating with physicians, nursing staff, technicians and medical assistants.
Education and Training
Associate of Applied Science: Medical Information, Expected in 12/2015 to Hudson Valley Community College - Troy, NY
GPA:

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Resume Overview

School Attended

  • Hudson Valley Community College

Job Titles Held:

  • QA Specialist
  • Receptionist
  • CR and Phlebotomy

Degrees

  • Associate of Applied Science

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